| NPI | 1780637587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 144326) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN144326/APN11254) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 11254) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-01-11 |