| NPI | 1134440001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60443749) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 16443) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4234) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2014-11-19 |