| NPI | 1356339634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 9398) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 73492) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2013-12-16 |