| NPI | 1417913989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN08946) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC000125) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-063395) | |
| 163W00000X Registered Nurse (Licence: AL RN1-063395) | |
| 163W00000X Registered Nurse (Licence: FL RN799782) | |
| 163W00000X Registered Nurse (Licence: TN RN44231) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-08-05 |