| NPI | 1477882314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 14772) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 136419) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901381) | |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2016-12-30 |