NPI | 1679869929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP06514) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN113322) |
Enumeration Date | 2011-06-24 |
Last Update Date | 2023-08-21 |