| NPI | 1831795681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1028639) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 901042) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2021-02-23 |