| NPI | 1134169121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 830983) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA rn084924) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-11-24 |