| NPI | 1932612637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136205) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 888176) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 117083) | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2022-10-11 |