| NPI | 1730321878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R185737) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201401678CRNA) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2016-04-17 |