| NPI | 1225455231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125803) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 798733) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2023-04-11 |