| NPI | 1215164660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9200988) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9200988) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2012-06-21 |