| NPI | 1588979868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 087317) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9279106) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2015-02-11 |