| NPI | 1447130976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1240535) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-184963) |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2026-08-04 |