| NPI | 1558395061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000010855) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN158635 CRNA) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-07-13 |