| NPI | 1336693779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R246319) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7204275-3102) |
| 163W00000X Registered Nurse (Licence: WV 94115) | |
| 163W00000X Registered Nurse (Licence: OH 416967) | |
| 163W00000X Registered Nurse (Licence: TX 905685) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP133046) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN658978) | |
| Enumeration Date | 2016-08-14 |
| Last Update Date | 2022-02-15 |