NPI | 1518090067 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 15409) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA12182) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN15409) | |
Enumeration Date | 2007-03-13 |
Last Update Date | 2024-04-10 |