| NPI | 1689766024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 635517) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 127966) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 107747) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 2976A) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2022-01-27 |