| NPI | 1134130586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1113205) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28055707A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN245406) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-02-28 |