| NPI | 1124356654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 601615) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA3932) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2011-03-24 |