| NPI | 1144680216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130150) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 791883) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D151008) | |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2021-06-04 |