| NPI | 1376813949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000018740) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 143755) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28217693A) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2020-09-04 |