| NPI | 1427148683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 000196) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E34306) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-05-19 |