NPI | 1003380429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001692) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61080718) |
367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021021) | |
Enumeration Date | 2019-01-18 |
Last Update Date | 2024-06-13 |