NPI | 1154694602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9338743) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R177483) |
Enumeration Date | 2012-02-14 |
Last Update Date | 2023-09-27 |