| NPI | 1043275241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 3375) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WI 132736-030) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-06-07 |