| NPI | 1588935332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121346) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 717697) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2023-09-21 |