| NPI | 1861723967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN14704) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN119579) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-07-12 |