| NPI | 1356773394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP124034) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 768586) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2019-08-12 |