| NPI | 1750457362 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118017) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 767221) | 
| 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN 067122) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP 02726) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 046058 AANA) | |
| Enumeration Date | 2006-11-27 | 
| Last Update Date | 2024-12-30 |