| NPI | 1891379541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1046379) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-150274) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2023-10-13 |