| NPI | 1386476554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041549498) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA ARNP.AP.70132391-NP) |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2026-06-26 |