| NPI | 1245559343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D-111082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007013208) |
| 163W00000X Registered Nurse (Licence: KS 14-100965-102) | |
| 163W00000X Registered Nurse (Licence: OK R98156) | |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2012-02-09 |