| NPI | 1811236862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP123232) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 827798) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2022-11-02 |