| NPI | 1427628841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN682785) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN682785) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 141270) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2022-10-12 |