| NPI | 1326479304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125524) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 811421) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2021-11-09 |