| NPI | 1992173280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130194) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN217185) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2016-02-08 |