| NPI | 1811218365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119097) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX AP119097) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 697978) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2023-08-14 |