| NPI | 1972781771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121819) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11001368) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY RN 1101493) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2019-04-16 |