| NPI | 1225332521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119853) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 716616) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2022-11-28 |