NPI | 1083160873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5517) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 113028) |
Enumeration Date | 2016-08-31 |
Last Update Date | 2025-03-27 |