| NPI | 1821743683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9342738) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11019611) |
| Enumeration Date | 2022-02-19 |
| Last Update Date | 2022-06-01 |