NPI | 1629078381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 85103) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN292083-1) |
367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN357151L) | |
Enumeration Date | 2005-07-26 |
Last Update Date | 2022-04-08 |