NPI | 1740624006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN277255) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RN49603) |
Enumeration Date | 2013-04-17 |
Last Update Date | 2020-06-27 |