| NPI | 1598712606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 589465) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 72515) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2009-03-03 |