| NPI | 1073692638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 74288) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN apn0000012015) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2022-04-09 |