NPI | 1083780142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN0509030) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 092978-23) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2025-05-05 |