| NPI | 1811544281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 124345) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TN 124345) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-26 |