| NPI | 1326150350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP04856) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 04856) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-05-06 |