| NPI | 1780255174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC006006) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: DC RN1047707) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2023-11-06 |