NPI | 1609108398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60134957) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D177487) |
Enumeration Date | 2010-02-04 |
Last Update Date | 2024-02-09 |