| NPI | 1922190073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 130302) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2008-10-09 |