| NPI | 1376975516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP124167) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 759412) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2024-02-13 |