| NPI | 1740759273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP140790) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 086956-23) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10005218) | |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2023-05-12 |