NPI | 1043418981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP09899) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-111160) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901463) | |
Enumeration Date | 2007-07-03 |
Last Update Date | 2023-08-21 |