| NPI | 1548295348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 1479742) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200460034CRNA) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2011-02-16 |