| NPI | 1598657827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024193906) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001321976) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |