NPI | 1164838124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9288505) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024189708) |
Enumeration Date | 2014-07-10 |
Last Update Date | 2025-04-23 |