| NPI | 1699714493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 668882) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 50784) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-10-05 |