| NPI | 1952602799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN529315L) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN-529315) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2014-11-12 |