| NPI | 1487472577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1075045) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002475) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 151670) | |
| Enumeration Date | 2024-09-28 |
| Last Update Date | 2026-05-13 |