| NPI | 1184644718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN086754) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 086754) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-11-01 |