| NPI | 1255369146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN051268) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA R051268) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2014-05-06 |