NPI | 1548528201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 17824) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 102323) |
Enumeration Date | 2012-05-01 |
Last Update Date | 2021-12-29 |