| NPI | 1578348793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28271339A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041.474349) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28271339A) | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2025-06-28 |