| NPI | 1437146842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9276267) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 134745) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2019-04-15 |