NPI | 1174568364 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 53805) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9226462) |
Enumeration Date | 2006-06-19 |
Last Update Date | 2022-03-22 |