| NPI | 1689059867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1156962) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 189869) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2024-08-22 |