| NPI | 1457587867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP122311) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 273580) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2016-03-11 |