| NPI | 1407838840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM R35471) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 244696) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2008-06-17 |