| NPI | 1932085990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 8033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001319348) |
| 163W00000X Registered Nurse (Licence: NY 772350) | |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-10-27 |