| NPI | 1619913779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 719644) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN530525L) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3314) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 775203) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2007-07-08 |