| NPI | 1750353694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0081649) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 625143) |
| Enumeration Date | 2006-02-05 |
| Last Update Date | 2010-07-26 |