| NPI | 1518534882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 26204) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SC RN.253180R) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN258470) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2022-08-10 |