| NPI | 1336135029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 9371) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN RN71433) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2024-11-26 |