| NPI | 1285931212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP127887) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 4418) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R895453) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9399059) | |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2015-10-13 |