NPI | 1255755658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN243970) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RN38566) |
Enumeration Date | 2014-02-06 |
Last Update Date | 2021-12-13 |