| NPI | 1487659538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 087006090CR) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30004374) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-07-08 |