| NPI | 1659556470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118341) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 698498) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200860007CRNA) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2016-04-04 |