| NPI | 1811162076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 3784) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT cp43081) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2015-03-19 |