NPI | 1114164035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3005900) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 47061) |
367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019954) | |
Enumeration Date | 2009-01-14 |
Last Update Date | 2023-12-06 |