| NPI | 1245202860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GU NP0141) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2715) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA2715) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GU RE1929) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2017-01-12 |