| NPI | 1700552627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 33347) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 0000227922) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2023-02-02 |