NPI | 1306268032 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.18432.NA) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA133028) |
Enumeration Date | 2014-01-15 |
Last Update Date | 2017-06-01 |