| NPI | 1366439333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 322039) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 137379) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2007-07-08 |