| NPI | 1699165209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP127291) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 187091) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2020-07-14 |