NPI | 1124324678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 090850-23) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169171) |
Enumeration Date | 2011-02-01 |
Last Update Date | 2023-06-02 |