| NPI | 1992956098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN13953) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN128981) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119967) | |
| 163W00000X Registered Nurse (Licence: TX RN816792) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 816792) | |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2024-01-25 |