| NPI | 1417968371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1450662) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL ARNP1450662) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2013-01-18 |