| NPI | 1013076736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 652839) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA3113) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2010-07-22 |