| NPI | 1598032013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 562) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 615393) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 825230) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ crna1131) | |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2016-10-06 |