| NPI | 1992801708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2364) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP104471) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 550645) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2021-01-25 |