| NPI | 1750457362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 046058 AANA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN 067122) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP 02726) | |
| 163W00000X Registered Nurse (Licence: TX 767221) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2012-05-17 |