| NPI | 1205182144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP129438) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 104083) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2023-01-06 |