NPI | 1164105433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 223442) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002261) |
Enumeration Date | 2023-08-11 |
Last Update Date | 2024-10-06 |