| NPI | 1467782946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118651) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 776837) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2020-09-11 |