| NPI | 1467831933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP137151) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 111786) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2025-11-24 |