| NPI | 1831070689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002749) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 286010) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 286010) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95255383) | |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-11-24 |