| NPI | 1467280008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1177067) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 915308) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-11-14 |