| NPI | 1548557473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120528) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 801071) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2022-09-22 |