NPI | 1023826153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1193924) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 986675) |
Enumeration Date | 2024-12-20 |
Last Update Date | 2025-04-29 |