| NPI | 1851042832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 8994741-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 8994741-8901) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |