| NPI | 1902294937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP127350) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 776050) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2024-06-28 |