NPI | 1396166344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9284211) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9284211) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN253957) | |
Enumeration Date | 2013-12-18 |
Last Update Date | 2023-01-10 |