| NPI | 1497566046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D182887) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 83189) |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-23 |