NPI | 1215265400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 307056) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 359) |
Enumeration Date | 2009-11-25 |
Last Update Date | 2024-10-30 |