NPI | 1255362133 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04287) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN082587) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2023-03-07 |