| NPI | 1770537136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN085125) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04031) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-09-13 |