NPI | 1417373788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC002743) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 23203) |
367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5827) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: PA 102534) | |
Enumeration Date | 2014-03-11 |
Last Update Date | 2022-06-23 |