| NPI | 1548407794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP117548) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 703394) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2022-07-22 |