| NPI | 1477889103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3886) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 589996) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 507451) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 589996) | |
| Enumeration Date | 2009-10-31 |
| Last Update Date | 2014-12-19 |