| NPI | 1346236254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 1450962) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN150906 NA03283) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2012-10-04 |