NPI | 1124506290 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN626825) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2323193) |
Enumeration Date | 2018-08-01 |
Last Update Date | 2024-02-09 |