| NPI | 1518078724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9278749) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY RN534440) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 5344401) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 077275) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-07-05 |