| NPI | 1518067487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN105739) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN12203) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN128491) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-11-27 |