| NPI | 1740228501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP112158) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9181218) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2946) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2016-07-19 |