| NPI | 1912279506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP122960) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 87897) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 710786) | |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2020-06-03 |