| NPI | 1154427680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN3457) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 186687) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2008-03-18 |