| NPI | 1477424471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101971) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NE 93232) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2026-01-22 |