| NPI | 1437109428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125339) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-098006) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-04-28 |