| NPI | 1487028189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9366405) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 700952) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28180492A) | |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2023-05-18 |