NPI | 1598768947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28193939A) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D-093513) |
Enumeration Date | 2005-05-31 |
Last Update Date | 2021-03-31 |