| NPI | 1467196469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 0997628-CRNA) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO 1621817) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-06-14 |