| NPI | 1386626323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01338) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R699683) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2016-09-17 |