| NPI | 1346206158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 050984) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 5200771) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 093447) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2010-04-14 |