NPI | 1346241288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11011995) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 213881) |
Enumeration Date | 2005-08-02 |
Last Update Date | 2024-12-09 |