| NPI | 1700105483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120873) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 2009004325) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2010013561) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 817217) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2022-08-18 |