NPI | 1770928244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-881A) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60332807) |
367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1529) | |
Enumeration Date | 2013-05-09 |
Last Update Date | 2021-11-03 |