| NPI | 1942699137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP127208) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 737653) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2024-10-21 |