| NPI | 1013973601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704208184) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4704208184) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2010-11-18 |