| NPI | 1861679946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN13029) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN141314) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2008-06-17 |