NPI | 1154399608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9334636) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 55137) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2019-09-18 |