| NPI | 1225282379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R129485) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DC RN63042) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2010-09-16 |