| NPI | 1851805303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136553) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA GAA-CRNA002112) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA243066) | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2024-10-01 |