NPI | 1356132427 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2323337) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 842100-01) |
Enumeration Date | 2025-05-16 |
Last Update Date | 2025-08-01 |