| NPI | 1699887356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN14724) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001181645) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024165334) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4016623) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-04-02 |