NPI | 1902535271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R239485) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R239485) |
163W00000X Registered Nurse (Licence: MD R239485) | |
Enumeration Date | 2022-06-10 |
Last Update Date | 2025-09-25 |