| NPI | 1629392378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118860) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 684097) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2018-02-09 |