| NPI | 1568560407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN-096621-AP04753) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04753) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2010-12-14 |