| NPI | 1467463208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60207660) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 264805-4406) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-03-24 |