| NPI | 1407894801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APRN3174) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-305802) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN157615) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2009-08-17 |