| NPI | 1851103576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1053897) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 152358) |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-03-26 |