| NPI | 1649222837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 727861) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 2815838) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2014-04-15 |