| NPI | 1942548292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN190800) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO apn 0990619) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 0990619) | |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2016-04-29 |