| NPI | 1093045999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP123460) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002786) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2016-06-07 |