NPI | 1619188604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901434) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 093642) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX 779617) | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2023-01-30 |