| NPI | 1346338951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: NC 31836) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 031836) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-05-21 |