| NPI | 1093967457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 22272) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000013836) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 626135-1) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN0000167421) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2023-08-14 |