| NPI | 1649373549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1984732) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 1984732) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-09-10 |