| NPI | 1831941392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA243055) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.459526) |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-08-05 |