| NPI | 1811953284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 812010) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 13846) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C01485) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-11-02 |