| NPI | 1376542803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10647) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN10647) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28156078A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 051663) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2019-01-23 |