NPI | 1427054089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 989) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA rn178935) |
363L00000X Nurse Practitioner (Licence: NC 5015807) | |
Enumeration Date | 2005-06-28 |
Last Update Date | 2023-11-21 |