| NPI | 1831450246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN16499) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN rn153797) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2023-10-26 |