NPI | 1255892477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11008947) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019937) |
Enumeration Date | 2019-03-29 |
Last Update Date | 2020-12-26 |