| NPI | 1750351870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1066846) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 1066846) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2010-09-23 |