NPI | 1508240219 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01503) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1152) |
163W00000X Registered Nurse (Licence: AZ RN152568) | |
Enumeration Date | 2015-07-13 |
Last Update Date | 2017-10-24 |