| NPI | 1043784788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP140473) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 839703) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2023-03-09 |