| NPI | 1427009190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 12080) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR R63074) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2016-05-18 |