| NPI | 1457547416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP2842272) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3534) |
| Enumeration Date | 2007-09-23 |
| Last Update Date | 2008-10-08 |