| NPI | 1811949696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP114535) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 642462) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-07-22 |