| NPI | 1275871881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9378022) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PR 25498) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PR 001593) | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2019-05-29 |