| NPI | 1841431087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN14033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 14033) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 26564) | |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2022-10-20 |