| NPI | 1598042541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP132459) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.394636) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 117109) | |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2023-11-09 |