| NPI | 1174038376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 23708) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 118544) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 118544) | |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2019-07-25 |