| NPI | 1417923301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN109260) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10075) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN141605) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |