| NPI | 1235173667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX API09103) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 656504) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-04-21 |