| NPI | 1669475315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS A810169) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000010910) |
| 163W00000X Registered Nurse (Licence: TN RN0000136483) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MS RN863786) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2011-03-10 |