| NPI | 1033627260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136225) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 828634) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10000562) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2024-01-03 |