| NPI | 1134374788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN13633) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 26701) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN114034) | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2023-01-05 |