| NPI | 1134159403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP113427) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 706259) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-03-20 |