| NPI | 1154399087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 725766) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX RN725766) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2011-12-16 |