| NPI | 1952439978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 2963-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 126855-30) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2013-07-02 |