| NPI | 1093807646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1627772) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28171527A) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2018-04-05 |