NPI | 1306071204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN2742162) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN 2742162) |
Enumeration Date | 2009-05-20 |
Last Update Date | 2019-05-04 |