| NPI | 1588638308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN1442) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN103413) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024133639) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2017-01-14 |