| NPI | 1518056134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 1813) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0010) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 034999) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ RN075834) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-09-13 |