| NPI | 1871001727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136204) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0004263-C-CRNA) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2023-09-28 |