| NPI | 1720396898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO RN.0150103) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209008275) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2014-02-12 |