| NPI | 1144861626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1179754) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28301179A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 873088) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 639739) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558266-111) | |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2026-04-04 |