| NPI | 1992939581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101090) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 60065) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-08-24 |