| NPI | 1487707741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 199460-4406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN61583) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000347) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 199460-4406) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2019-06-30 |