| NPI | 1487694048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 148194) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN15494) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C01211) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-12-27 |