| NPI | 1982034385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9293274) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9293274) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2015-02-13 |