| NPI | 1922583475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 6845598-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 814877) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2019-09-09 |