| NPI | 1851369474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3313212) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN3313212) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2015-03-19 |