| NPI | 1245201730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX RN752822) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP03650) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 752822) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP1156860) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2018-08-23 |