| NPI | 1629176169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28077464A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-001985) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 168609 Registry#4405) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704251112) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-08-12 |