| NPI | 1972772184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP126480) |
| Additional Taxonomies | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 1941) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2292611) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9232638) | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2022-08-18 |