| NPI | 1467438168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28135627A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1047435) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN147036) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2011-05-26 |