| NPI | 1831282284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2268707) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 79915) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2016-07-20 |