| NPI | 1407826688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP110997) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN- 45487) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 599359) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-12-13 |