| NPI | 1831116318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR R68220) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 75444) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-04-05 |