| NPI | 1396156592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125808) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 768942) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2023-03-30 |