| NPI | 1396063178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR000739) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD R033777) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2013-01-03 |