| NPI | 1306143896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120161) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA ap06361) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2018-07-26 |