| NPI | 1679935001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1123015) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60815513) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ID CRNA58296) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-09-13 |