| NPI | 1518014166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901433) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9215601) |
| 163W00000X Registered Nurse (Licence: GA RN187112) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN187112) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-10 |