| NPI | 1720403173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125372) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024179520) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-106956) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN187388) | |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2024-05-01 |