| NPI | 1114953114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118567) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 46116) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 786750) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2021-01-18 |