| NPI | 1447297528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN1787402) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 066569) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2022-02-28 |