| NPI | 1447210257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9173128) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA APRN231221) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2013-07-11 |