| NPI | 1437300290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP117475) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 720807) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2021-01-21 |