| NPI | 1992191225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 68419) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D139751) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |