| NPI | 1720054760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN65446) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN09309) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN126312) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |