| NPI | 1942254263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1072095) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 1-072095) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-09-21 |