| NPI | 1497642730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 124649) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: AR 124649) |
| Enumeration Date | 2025-06-19 |
| Last Update Date | 2025-08-06 |