| NPI | 1447802301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP142332) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 828654) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 828654) | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2022-02-22 |