| NPI | 1427414374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 10292276-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 10292276-8901) |
| 163W00000X Registered Nurse (Licence: UT 7205762-3102) | |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2024-03-04 |