| NPI | 1225552607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 265801) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 864558) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-03-14 |