NPI | 1184729469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11036257) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NR10436300) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2025-09-17 |