| NPI | 1942522248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 24168886) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 180705) |
| Enumeration Date | 2010-02-28 |
| Last Update Date | 2012-01-01 |