| NPI | 1881999472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121455) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 678929) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN585727) | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2022-11-29 |