| NPI | 1336412337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60585194) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209009399) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2018-12-11 |