| NPI | 1942918503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 40853) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 0000242529) |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2026-02-27 |