| NPI | 1437417417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002938) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R081545) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2015-06-16 |