| NPI | 1881469625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 303489) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: AZ RN201792) |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2024-04-22 |