| NPI | 1952230724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 28279608C) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 70137754) |
| Enumeration Date | 2026-05-18 |
| Last Update Date | 2026-05-26 |