| NPI | 1770860975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28224409A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 06528323) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2016-05-09 |