| NPI | 1154536373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 037099-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 0307992311) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2018-02-20 |