| NPI | 1275561359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP02556) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 591952) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2016-08-01 |