| NPI | 1669034153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX APRN143509) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11021707) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2024-06-12 |