| NPI | 1922302785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 15649) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 167906) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 810527) | |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2024-01-08 |