| NPI | 1043280001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR000216) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 100337) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2008-08-07 |