| NPI | 1023038486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60408388) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME R031739) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-11-11 |