| NPI | 1083785737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 586642) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 206216) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA143009) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-04-26 |