| NPI | 1477984227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP127063) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 87186) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2015-10-27 |