| NPI | 1518090067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 15409) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA12182) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN15409) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2024-04-10 |