| NPI | 1932513553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0000484) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 165852) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2016-04-21 |