| NPI | 1982032884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP124455) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 93322) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2024-04-10 |