| NPI | 1366577314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3434) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN586748) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2014-06-09 |