| NPI | 1396013801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9248348) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2021-02-18 |