| NPI | 1851531057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP05693) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 081948) |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2016-11-17 |