| NPI | 1376519538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10870) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN122011) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN156796) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-07-08 |