| NPI | 1275511941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9198870) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-102783) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN129660 CRNA) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2010-10-26 |