| NPI | 1306122676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121392) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 725249) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2022-02-18 |