| NPI | 1881660033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN11239) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN107152) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN127955) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2010-04-30 |