| NPI | 1568466449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9252584) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN342424L) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ APN 26NJ00213800) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2010-08-01 |