| NPI | 1447431978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP05423) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 102875) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2010-12-15 |