| NPI | 1801675475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 073721-23) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NH 073721-21) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN746731) | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-09-27 |