| NPI | 1992967558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9225650) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM R64558) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2009-09-04 |