| NPI | 1245537323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119965) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 677665) |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2019-11-05 |