| NPI | 1881991339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 869357) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169214) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1477) | |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2021-07-20 |