| NPI | 1194185546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP131209) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R095063) |
| Enumeration Date | 2016-02-28 |
| Last Update Date | 2016-06-23 |