| NPI | 1538408091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0990790-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 77654838901) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 7765483-8901) | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2018-12-04 |