| NPI | 1427096429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0598) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2500) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 825688) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-05-12 |