| NPI | 1518232735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DC RN1010072) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R171923) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2015-03-03 |