| NPI | 1295245009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9466969) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN659544) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2018-05-24 |