| NPI | 1962577742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP129454) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 888274) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9258675) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN304599L) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-11-05 |