| NPI | 1396283834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9342160) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9342160) |
| Enumeration Date | 2017-02-04 |
| Last Update Date | 2017-03-31 |