| NPI | 1033194618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3263422) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 274517) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2007-12-14 |