| NPI | 1598136434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP133217) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 588656-1) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 103612) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 908544) | |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2022-05-09 |