NPI | 1972058071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9326204) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN193624) |
Enumeration Date | 2016-08-18 |
Last Update Date | 2021-03-05 |