| NPI | 1225334790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119935) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX AP119935) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 712738) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2024-06-21 |