| NPI | 1144277575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0562) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704149628) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ RN151239) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2017-04-27 |