| NPI | 1588137251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 124359) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000203021) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000026407) | |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2021-06-16 |