| NPI | 1023283223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9278003) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA rn176034) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002830) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2022-05-22 |