| NPI | 1548544430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125019) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 233749) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 688669) | |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2022-06-23 |