| NPI | 1750546552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN13575) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN143736) |
| 163W00000X Registered Nurse (Licence: GA RN177468) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3005846) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2024-02-13 |