| NPI | 1245429513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP132503) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00151577) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2017-03-24 |