| NPI | 1245970300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1082986) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 904937) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 137418) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-10-31 |