| NPI | 1326370867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 17246) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168650) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3011113) | |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2017-02-27 |