| NPI | 1588311716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11032267) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KS 13-114807-111) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020546) | |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2024-04-17 |