| NPI | 1487798732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP117926) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP05107) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-05-01 |