NPI | 1699103911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1011) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD CRNA1011) |
Enumeration Date | 2013-10-23 |
Last Update Date | 2021-06-16 |