| NPI | 1336471267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 60330629) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 700881) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2020-07-09 |