| NPI | 1043288541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R875676) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28162301a) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-09-05 |