| NPI | 1942780283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 8325381-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 243252) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 60592) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D176790) | |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2024-02-07 |