| NPI | 1871977256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9408120) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9408120) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9408120) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2016-10-28 |