| NPI | 1477181816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1086964) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11019764) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 35762) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-03-01 |