| NPI | 1831938836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1167846) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 900648) |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2024-06-30 |