| NPI | 1346878485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2020023108) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024188074) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AR R096962) | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-08-27 |