| NPI | 1922209998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN8319) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN8319) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN RN135716) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2011-04-20 |