NPI | 1174070973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9445275) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PR 110099) |
Enumeration Date | 2016-09-09 |
Last Update Date | 2025-05-19 |