| NPI | 1215039979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R691259) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000009584) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C00318 CRNA) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-07-08 |