| NPI | 1265101018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 31490) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 211952) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 136181) | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2024-04-11 |