| NPI | 1285805739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116540) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 682201) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2020-09-04 |