| NPI | 1003882291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10767) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN99856) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN163737) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2016-04-15 |