| NPI | 1184861395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN135627) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002948) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2020-03-18 |