NPI | 1356326904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN10005202) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61494483W) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2024-05-22 |