NPI | 1629084546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9432897) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 171042) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2020-10-26 |