| NPI | 1861438012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R49499) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK R0049499) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 643959) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2015-01-07 |