| NPI | 1356869325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 9050-33) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4012936) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 32989) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 770560) | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2024-02-15 |