| NPI | 1316627011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 226087) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: AR R107202) |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-09-17 |