| NPI | 1790922359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 065877-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 065877-21) |
| 163W00000X Registered Nurse (Licence: PA RN554340) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 081261) | |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2012-06-13 |