| NPI | 1881893725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 681543) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TX 681543) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-03-13 |