NPI | 1144610882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024173312) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA143055) |
Enumeration Date | 2015-02-03 |
Last Update Date | 2021-02-28 |