| NPI | 1932145257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA1942) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA RN321539) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2012-12-04 |