NPI | 1407268931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 269055) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 653057) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP128069) | |
Enumeration Date | 2014-06-02 |
Last Update Date | 2023-06-29 |