| NPI | 1922437995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP124956) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 121363) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 848029) | |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2021-06-23 |