| NPI | 1538244926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 3233) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 180631) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 052003) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-02-01 |