| NPI | 1356519177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 871625) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1992062) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2023-05-02 |