NPI | 1013724350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1186222) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 922541) |
Enumeration Date | 2024-12-11 |
Last Update Date | 2025-02-26 |