| NPI | 1346234531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN 9809) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN 91970) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C10187) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9257125) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2011-06-09 |