| NPI | 1437203379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201400538) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000031114) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 735992) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2022-05-17 |