| NPI | 1174587901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-097432) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN140624) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9267941) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2015-09-30 |