| NPI | 1437812575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11017579) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL RN9506691) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2022-03-01 |