| NPI | 1013949494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3220532) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA Apo4698) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-05-12 |