| NPI | 1245268366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 031334-23-11) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VT 1010049041) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-01-12 |