| NPI | 1821094046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN 3072412) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT R40669) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-097045) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 690232) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA RN491358/NA2011) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2010-11-24 |