NPI | 1578848412 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 16003) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3017086) |
Enumeration Date | 2011-10-11 |
Last Update Date | 2022-01-04 |