NPI | 1215982442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 1058) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R137002) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2024-07-31 |