| NPI | 1437101805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN 9090) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN 061215) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2011-06-09 |