| NPI | 1710947437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP101709) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 255639) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2022-11-10 |