| NPI | 1336444231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 15377) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN15377) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2014-04-24 |