| NPI | 1083780340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN524451L) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130539) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2023-08-07 |