| NPI | 1447414016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0001216921) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9171013) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R185644) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2015-01-14 |