| NPI | 1386985349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 765593) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 35134) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2014-11-10 |