| NPI | 1467506485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9285893) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R876497) |
| 163W00000X Registered Nurse (Licence: AL 1-082015) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-06-21 |