| NPI | 1275863714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9329559) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.007970) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 148864-30) | |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2011-10-21 |