| NPI | 1437458825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 101441) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 164879) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2011-03-24 |