| NPI | 1437779592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 27755) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10008152APRN-CRNA) |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2023-07-06 |