| NPI | 1487085312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP131577) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 809597) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2024-09-10 |