| NPI | 1497326201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11026503) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN619507) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN619507) | |
| Enumeration Date | 2021-07-03 |
| Last Update Date | 2023-07-05 |