| NPI | 1316188063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 765749) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX AP117825) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2024-01-24 |