| NPI | 1467498535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 10459) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 140556) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0001229638) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2015-11-21 |