| NPI | 1528034394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP037606) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 037606) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2008-01-16 |