NPI | 1801892641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 257003) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 395603) |
Enumeration Date | 2005-06-27 |
Last Update Date | 2021-05-15 |