| NPI | 1841518222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 84758) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 193276) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-10-05 |