| NPI | 1750529079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120163) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 2677162) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 103426) | |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2020-03-24 |