| NPI | 1467844019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000403) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 868861) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2019-10-14 |