| NPI | 1922311133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 5419392-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME AA103013) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2012-05-29 |