| NPI | 1245249234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60534430) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 231604/06391) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2016-07-12 |