| NPI | 1164489183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP126915) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C00309) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 72598) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000010344) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-10-09 |