| NPI | 1346599826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 17295) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 740971) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2013-11-14 |