| NPI | 1467831933 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP137151)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 111786)  | 
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 111786)  | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 111786)  | |
| Enumeration Date | 2015-05-29 | 
| Last Update Date | 2018-10-24 |