| NPI | 1518910231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 125591) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN125591/APN10903) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 10903) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 6013A) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2011-01-11 |