| NPI | 1659504645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN14335) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN141413) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2009-09-23 |