| NPI | 1881194116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 940902) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN239372) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN239372) | |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2023-07-12 |