| NPI | 1538225016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA2697) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2697) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2017-09-12 |