| NPI | 1467876581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9259040) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9259040) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9259040) | |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2023-10-03 |