| NPI | 1255337085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP01558) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 665182) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 68582-1558) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C01528) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2022-06-15 |