NPI | 1073505202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1726152) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 109696) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2016-10-13 |