NPI | 1740210061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA APO4029) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN089353) |
367500000X Nurse Anesthetist, Certified Registered (Licence: AR C02817) | |
Enumeration Date | 2006-07-03 |
Last Update Date | 2021-07-07 |