NPI | 1164659181 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11016312) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704284330) |
Enumeration Date | 2009-06-17 |
Last Update Date | 2024-09-05 |