NPI | 1053097576 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN632818) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 147498) |
Enumeration Date | 2023-06-27 |
Last Update Date | 2023-09-27 |