Individual
JASON DEAN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R034213
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000788
SD
Other
Enumeration date
02/09/2012
Last updated
05/02/2012
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