| NPI | 1144896580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1045613) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 133660) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-09-01 |