| NPI | 1033538566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 19354) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 169381) |
| Enumeration Date | 2014-04-13 |
| Last Update Date | 2022-03-03 |