| NPI | 1689601825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 083790) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 9826) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2011-06-27 |