| NPI | 1689952582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9282576) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 877258) |
| 163W00000X Registered Nurse (Licence: TX 714348) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704406335) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120606) | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2024-08-23 |