| NPI | 1912292467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120509) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 666549) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2021-12-16 |