| NPI | 1073840237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN505383L) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: PA RN505383L) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2015-02-24 |