| NPI | 1033188990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN542206) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 538854-1) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-06-22 |