| NPI | 1437858792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024189317) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001263136) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-03-12 |