| NPI | 1093076101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP122128) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX RN719729) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 719729) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2020-05-06 |