| NPI | 1871907857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP128298) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 878376) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000018814) | |
| 163W00000X Registered Nurse (Licence: UT 51446263102) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2021-08-02 |