| NPI | 1427260694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN100697-AP05221) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 100697) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2010-08-18 |