| NPI | 1033181805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60591499) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R146353-6) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 160949-030) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2015-10-27 |