| NPI | 1386244937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11010842) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9354353) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 134926) | |
| Enumeration Date | 2020-10-31 |
| Last Update Date | 2021-01-04 |