| NPI | 1841252434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP109355) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 658790) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2022-08-11 |