| NPI | 1275103038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901852) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MS 896972) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2023-05-09 |