| NPI | 1326090978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN11982) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN152219) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN149603) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-03-27 |