| NPI | 1366511396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 884211) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 184182) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2015-09-23 |