NPI | 1780777698 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 552832) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: HI APRN-772) |
367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3145) | |
Enumeration Date | 2006-10-02 |
Last Update Date | 2021-11-29 |