| NPI | 1598424665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11024029) |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy (Licence: FL 9444887) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2023-02-15 |