| NPI | 1881047215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1112555) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 54118) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-12-06 |