NPI | 1740574805 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.12406) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL COA12406NA) |
Enumeration Date | 2011-06-07 |
Last Update Date | 2024-04-05 |