| NPI | 1811559826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP142449) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 823247) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 823247) | |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2021-11-03 |