| NPI | 1912003260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C00348) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R 89957) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP108657) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2018-05-09 |