| NPI | 1437468865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11041427) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 559070) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2025-10-06 |