| NPI | 1811987001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN CERT # 50404) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9178672) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2016-03-03 |