| NPI | 1962823070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP124966) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 781844) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 100326) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 781844) | |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2020-09-01 |