| NPI | 1821470972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 229708) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP128316) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 29430) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 9218) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ TEMP301223) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-12-20 |