| NPI | 1477552172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP114181) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM R32442) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2022-11-30 |