| NPI | 1871604165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121998) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 828741) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R859892) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-04-28 |