| NPI | 1326208141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 613997) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 080521-23) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2024-12-05 |