| NPI | 1528286697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 073067-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9187648) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2016-06-03 |