| NPI | 1326216177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 732862) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 151978) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2010-09-22 |