| NPI | 1750331328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP113879) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 654919) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2022-07-19 |