| NPI | 1598878183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP107795) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 638204) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2019-10-16 |