| NPI | 1194137562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9334397) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP133263) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL RN9334397) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9334397) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2024-05-19 |