| NPI | 1285727578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28089297A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1053520) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN602136) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2009-03-06 |