| NPI | 1528158813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9274281) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ NR117131) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2009-01-20 |