| NPI | 1467416354 |
|---|---|
| Former Name | SAM GIBSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 2992) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-065636) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2016-12-21 |