| NPI | 1558349985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 029078-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 029078-23-11) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2015-07-16 |