| NPI | 1225018088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN AANA 31399) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN 9624) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN 83185) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-07-27 |