NPI | 1053608109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 3220) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D-127601) |
Enumeration Date | 2011-07-08 |
Last Update Date | 2022-04-19 |