| NPI | 1740821099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001216) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP143400) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: UT 7122459-3102) | |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-11-06 |