| NPI | 1538941208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 78566) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: UT 10646505-3102) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2024-02-19 |