| NPI | 1346335262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN12238) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN87058) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-06-18 |