| NPI | 1245565050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 20912) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN183471CRNA) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2018-10-11 |