| NPI | 1902843782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28162309A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9188704) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 5135A) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2008-06-11 |