| NPI | 1477231066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 27845) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: GA 247828) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-05-23 |