| NPI | 1730248980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 85227) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0085227) |
| 163W00000X Registered Nurse (Licence: TX 692925) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2016-04-12 |