| NPI | 1417346248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9339848) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01520) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2018-08-24 |