| NPI | 1558785527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP141136) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR13628600) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00488400) | |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2019-11-04 |