NPI | 1760894604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9311009) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9311009) |
Enumeration Date | 2014-05-27 |
Last Update Date | 2023-12-28 |