| NPI | 1992777304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP111085) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 500207) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-06-23 |