| NPI | 1699842997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R180390) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168000) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2011-04-15 |