| NPI | 1720159544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 22969) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN053794) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000009033) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN053794 CRNA) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-01-24 |