NPI | 1407330848 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11012703) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024177215) |
Enumeration Date | 2018-09-21 |
Last Update Date | 2024-02-20 |