| NPI | 1285677278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID N-10526) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID rna68) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2011-06-14 |