| NPI | 1891753059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 694907) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 50441) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-04-05 |