| NPI | 1942291174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 1831672) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN229116L) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000009971) | |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2008-01-16 |