NPI | 1225661622 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11013117) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 135494) |
163W00000X Registered Nurse (Licence: FL 9564462) | |
163W00000X Registered Nurse (Licence: NY 815139) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: NY 135494) | |
Enumeration Date | 2020-02-14 |
Last Update Date | 2024-06-12 |