| NPI | 1447600010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1120723) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1934) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 235004-6) | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2024-01-22 |