| NPI | 1548284417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 391867-1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704195077) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-08-01 |