NPI | 1386680601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R121789) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 572078) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2023-03-07 |