| NPI | 1902972219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP2603662) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 575043) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2016-05-24 |