| NPI | 1437526704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 21496) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS A810709) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2016-10-18 |