NPI | 1588934269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9265082) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL APRN9265082) |
367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9265082) | |
Enumeration Date | 2012-01-11 |
Last Update Date | 2023-04-02 |