| NPI | 1184606881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 41129) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 056492) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D056492) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2007-07-08 |