| NPI | 1023293032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116713) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 680543) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2020-06-11 |