| NPI | 1366528093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0637) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 040416) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000203) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2018-05-08 |