| NPI | 1134248396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9353970) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: HI RN-50421) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2013-03-01 |