| NPI | 1992146062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP123686) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60634597) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 836217) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2019-04-10 |