NPI | 1053981159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 268939) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11017127) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL RN9410661) | |
Enumeration Date | 2021-06-30 |
Last Update Date | 2024-02-13 |