| NPI | 1134196017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 070172) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN116871) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN101773) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10846) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-10-27 |