NPI | 1497770788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-00587) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 20421) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2019-06-25 |