| NPI | 1831155753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 040706) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001-097714) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024-097714) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 001097714) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-11-21 |