| NPI | 1285783431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP109844) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK M129476) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 664561) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2019-10-22 |