| NPI | 1174550198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9192369) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN274756) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-12-23 |