| NPI | 1831610450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP135094) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 925507) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |