| NPI | 1295291482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1006762) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 747851) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2024-09-17 |