| NPI | 1417268376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 728692) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC000802) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2014-01-19 |