| NPI | 1548236409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 69677) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10713) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN143453) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN170816) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-06-28 |