| NPI | 1235081845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 8441) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 274234) |
| Enumeration Date | 2026-02-14 |
| Last Update Date | 2026-09-10 |