| NPI | 1548297534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L10032319) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN532609) |
| 163W00000X Registered Nurse (Licence: DE L1-0032319) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00483) | |
| 367H00000X Anesthesiologist Assistant (Licence: DE L10032319) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2009-12-11 |