NPI | 1578794483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 14478) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 122581) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MS 810575) | |
Enumeration Date | 2009-07-28 |
Last Update Date | 2023-11-30 |