| NPI | 1750765707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130112) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 799113) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2016-01-26 |