| NPI | 1225532518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP137762) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 743248) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-03-01 |