| NPI | 1447023098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 11107610-4406) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 11107610-3102) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-12-22 |