| NPI | 1275081846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 21725) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 179740) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2018-04-23 |