| NPI | 1780656108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30007241) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 684049) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2014-12-16 |