| NPI | 1134557853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000437) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 6833204-4406) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2018-12-28 |