NPI | 1053044891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD cr001119) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: SD R042289) |
Enumeration Date | 2022-07-08 |
Last Update Date | 2022-08-25 |