| NPI | 1356418982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP05006) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 101632) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2010-12-06 |