NPI | 1265687958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9175172) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9175172) |
Enumeration Date | 2008-11-21 |
Last Update Date | 2023-07-03 |