NPI | 1568041481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11026371) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9467216) |
Enumeration Date | 2021-04-07 |
Last Update Date | 2023-06-22 |