| NPI | 1649784331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0995735-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136215) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11019508) | |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2025-11-17 |