| NPI | 1134456791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9254249) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0083178) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2012-06-26 |