| NPI | 1992034649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN238455) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 672368) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2019-10-17 |