| NPI | 1881931897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA4367) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 651476) |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2013-05-24 |