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 |