| NPI | 1306604541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95081979) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 342114) |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2026-08-03 |