| NPI | 1699944751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 79018) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1000567) |
| 207L00000X Anesthesiology (Licence: NY 559930) | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2020-08-28 |