| NPI | 1851562847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60332822) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN195823 CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D119508) | |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2015-07-13 |