| NPI | 1912969437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9314550) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN047503) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2011-11-30 |