| NPI | 1720398175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 065099-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 213865) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2011-09-13 |