NPI | 1053158006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA243052) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 148115) |
Enumeration Date | 2024-07-09 |
Last Update Date | 2025-04-01 |