| NPI | 1043570351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP122062) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 728339) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2021-11-05 |