| NPI | 1447797899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0999722.CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 240766) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP132884) | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2025-06-05 |