| NPI | 1093707051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000008921) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000042871) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-02-06 |