| NPI | 1346839826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1029036) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 813040) |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2024-07-24 |