| NPI | 1508495193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 144772) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 845732) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-02-19 |