NPI | 1033654835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 7673816-4406) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1378) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MT NUR-APRN-LIC-124537) | |
Enumeration Date | 2017-01-03 |
Last Update Date | 2024-04-24 |