| NPI | 1033155544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN098960) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA R098960) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2014-04-02 |