| NPI | 1639499130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119104) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 083079) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2022-06-29 |