| NPI | 1508824905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28181433A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 103360) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-07-21 |