| NPI | 1437747672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 11222365-4406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95063097) |
| 163W00000X Registered Nurse (Licence: UT 11222365-3102) | |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-02-02 |