| NPI | 1033172358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP117611) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 143173) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2023-01-26 |