| NPI | 1760779060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 088583-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120388) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 736858) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2022-08-08 |