| NPI | 1891725990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN345750L) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00249) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2016-04-13 |