NPI | 1124726831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 27960) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN268293) |
Enumeration Date | 2023-02-21 |
Last Update Date | 2024-03-15 |