NPI | 1144900234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 79307) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 876610) |
Enumeration Date | 2023-07-24 |
Last Update Date | 2025-08-27 |