| NPI | 1346489671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 082152) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 202866) |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2016-05-23 |