| NPI | 1891133948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9317621) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 1621452) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2016-10-04 |