| NPI | 1518269745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9309173) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 174004-2) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 174004-2) | |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2012-02-27 |