| NPI | 1588849590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116498) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 747631) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2023-09-20 |