NPI | 1922345446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP00000) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN124467) |
367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA223081) | |
Enumeration Date | 2013-01-04 |
Last Update Date | 2023-04-17 |