NPI | 1639139819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN230546) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R186467) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MA 230546) | |
Enumeration Date | 2006-03-23 |
Last Update Date | 2024-11-12 |