NPI | 1114996824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 4690) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 53072) |
Enumeration Date | 2006-03-15 |
Last Update Date | 2025-04-01 |