| NPI | 1750356630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN11256) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN74996) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN108737) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |