| NPI | 1053725853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN19010) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9335059) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN158445) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-08-06 |