| NPI | 1457348773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 10345) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 27158) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN127822) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2023-03-17 |