| NPI | 1801935200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7241) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 592385) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-05-22 |