| NPI | 1952497299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0086924) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 9454) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2015-07-29 |