| NPI | 1932762663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11016396) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 4873979-4406) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 125902) | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2023-02-27 |