NPI | 1063712974 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9373571) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020502) |
367500000X Nurse Anesthetist, Certified Registered (Licence: DE L1-0032184) | |
Enumeration Date | 2010-10-26 |
Last Update Date | 2022-05-24 |