| NPI | 1538805676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001815) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: UT 9808115-3102) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 137573) | |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-09-22 |