NPI | 1114276805 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 269181) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000489) |
Enumeration Date | 2012-09-10 |
Last Update Date | 2022-05-19 |