| NPI | 1154374437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04830) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 129053) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-11-17 |