| NPI | 1609227826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9375019) |
| Additional Taxonomies | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: UT 6703908-3102) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2023-05-11 |