NPI | 1780781443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9490042) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 69110) |
Enumeration Date | 2006-09-17 |
Last Update Date | 2021-01-24 |