| NPI | 1366517609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN118584) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5694225) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN193541) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 5360A) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2008-06-18 |