| NPI | 1881491322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 322940) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9463189) |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-06-26 |