| NPI | 1306117577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA36730) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI 36730) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2013-10-04 |