| NPI | 1477581825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 097000628RN) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200360037crna) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2018-08-17 |