| NPI | 1497045835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP08274) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 702883) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2019-02-28 |