| NPI | 1891090189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9309923) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9309923) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2022-06-25 |