NPI | 1356852941 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC002738) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024175483) |
367500000X Nurse Anesthetist, Certified Registered (Licence: HI APRN-2347) | |
Enumeration Date | 2017-10-23 |
Last Update Date | 2019-10-20 |