| NPI | 1639794324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901636) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 336781) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9309082) | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2026-03-17 |