| NPI | 1447368204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP122766) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704330417) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 9551) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2018-06-01 |