| NPI | 1659468023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP108250) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 643874) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2024-03-25 |