| NPI | 1780629527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9238304) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 512453) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 032066) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2011-04-06 |