| NPI | 1730433871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: HI APRN-1954) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0894) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2015-11-04 |