| NPI | 1467761825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119504) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX RN784471) |
| 363L00000X Nurse Practitioner (Licence: TX AP119504) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX CRNA84602) | |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2021-01-06 |