| NPI | 1205875457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT R34719) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 242394) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 534703-1) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-07-08 |