| NPI | 1578517959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WY 18607-0366) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4423A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WY 18607.366) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-03-17 |