| NPI | 1578020194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10013307APRN-CRNA) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: OR 201404876RN) |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2023-08-16 |