| NPI | 1336524669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 20451) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 119145) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2016-04-12 |