NPI | 1588799241 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP2971342) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 577707) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2007-07-08 |