| NPI | 1598736001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP108248) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 606699) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2017-03-20 |