| NPI | 1033117858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP112207) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 589295) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2022-07-08 |