| NPI | 1396722419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9247867) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA18640) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 031148) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2016-05-09 |