| NPI | 1952520132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C02660) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CTP-000039) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2014-10-23 |