| NPI | 1346386810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP114572) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 073847) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2026-07-17 |