| NPI | 1346211828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9280726) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA APRN04646) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2013-05-06 |