NPI | 1922302785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 15649) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 167906) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MS 810527) | |
Enumeration Date | 2011-01-07 |
Last Update Date | 2024-01-08 |