| NPI | 1760519078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP143692) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2275735) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 1053876) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 082366-23) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-03-25 |