| NPI | 1407934516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN163959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA NA3255) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN13224) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 5816A) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-03-04 |