NPI | 1245271949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT NUR-APRN-LIC-197289) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-080705) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2024-01-17 |