| NPI | 1952960825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP142205) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 831369) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2023-07-19 |