| NPI | 1730249533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX NA 685231) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP 3710) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA Nurse Anesth 2809) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN 9249717) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 101076) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-10-13 |