| NPI | 1346093127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2370279) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CT 165806) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CT 165806) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IA 173244) | |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2026-07-10 |