NPI | 1023018454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024167982) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 0024167982) |
Enumeration Date | 2005-07-28 |
Last Update Date | 2024-03-08 |