| NPI | 1700283736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 19665) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 171165) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2016-11-15 |