| NPI | 1881375657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AL 1-174846) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209030865) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-10-28 |