| NPI | 1588846786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 94107) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 686634) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2011-08-24 |