| NPI | 1528233426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN558153) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME AA083447) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2013-01-24 |