| NPI | 1891386306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN744240) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R207197) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD 133609) | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2022-08-16 |